Relationship between the risk factors for human papillomavirus infection and lower genital tract precursor lesion and cancer development in female transplant recipients

Martins, Caroline Alves de Oliveira; Guimarães, Isabel Cristina Chulvis do Val; Velarde, Luís Guillermo Coca

doi:10.1111/tid.12714

Cited by 4 publications

(5 citation statements)

References 38 publications

(39 reference statements)

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“…This incidence is consistent with the infection rate of 54.5%, and hr-HPV prevalence of 40%, reported by de Oliveira Martins et al in Brazilian RTR. 27 However, another cohort had a lower HPV infection prevalence, 27.1%, with a frequency of infection with hr-HPV genotypes of 17.4%. 18 We believe that the differences in this study compared with ours hinge on the fact that their participants were a decade older than ours at the time of transplantation; further, 50% of patients were sexually abstinent 6 months prior to the study and had a limited number of sexual partners, unlike our cohort of younger and sexually active patients.…”

Section: Discussionmentioning

confidence: 94%

Incidence of cervical intraepithelial lesions and human papilloma virus infection in female renal transplant recipients

Parra-Avila

Jiménez-Santana

Barrón-Sánchez

et al. 2021

Transplant Infectious Dis

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Background: Female renal transplant recipients (RTR) are at high risk of human papillomavirus (HPV)-related anogenital premalignancies and cancer. The aim of this study was to estimate the incidence of cervical intraepithelial lesions (IL) and HPV infection, and their associated factors, in Mexican RTR.Methods: This is a prospective cohort study conducted between January 2011 and December 2017. Demographic, clinical, and gynecological data were collected using a previously designed questionnaire. Gynecological examination, cervical cytology, and detection of high-and low-risk HPV DNA were undertaken prior to and after the renal transplant (RT). Colposcopically guided biopsies were obtained from patients who presented high grade squamous intraepithelial lesions (HSIL) during the followup period. Diagnoses were established according to the Bethesda system.Results: Among 130 RTR, 62 were eligible for our study. The overall incidence of IL was 17.7% (95% CI, 8% to 27%), (11/62 patients), at 25.6 ± 10.7 months post-RT. Nine out of the eleven affected patients had low-grade squamous intraepithelial lesions (81.8%) and only two had HSIL (18.2%). The incidence of HPV infection, determined in a subgroup of 30 RTR, was 53.3% (95% CI, 35% to 71%), (16 out of 30 patients), at 18.3 ± 8.9 months post-RT. High-risk HPV genotypes were present in 62.5% of HPV positive cases (10/16). In 11 patients (36.6%), HPV infection was not associated to IL. Conclusions:HPV infection and cervical IL are common in the early posttransplant period. Our findings support the need of screening for cervical cancer to detect precancerous changes in RTR and the need of strengthening the knowledge of medical personnel on this issue.

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Section: Discussionmentioning

confidence: 94%

Incidence of cervical intraepithelial lesions and human papilloma virus infection in female renal transplant recipients

Parra-Avila

Jiménez-Santana

Barrón-Sánchez

et al. 2021

Transplant Infectious Dis

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“…The hrHPV prevalence in RTRs varies in different areas, and most studies found a significantly higher prevalence of cervical hrHPV among RTRs, ranging from 6.9% to 62.8% ( 14 – 17 , 21 , 22 ). Our cohort of female RTRs showed an elevated overall HPV prevalence of 23.5%, higher than the control group (9.2%), similar to most studies.…”

Section: Discussionmentioning

confidence: 99%

“…The hrHPV prevalence in RTRs varies in different areas. Although some studies reported no difference in hrHPV infection rates between kidney transplant recipients and their matched controls ( 11 – 13 ), most studies confirmed a significantly higher prevalence of cervical hrHPV among RTRs ( 14 – 17 ). The 2019 American Society of Colposcopy and Cervical Pathology (ASCCP) consensus guidelines emphasized the importance of regular cervical cancer screening for patients with immunosuppression ( 18 ).…”

Section: Introductionmentioning

confidence: 94%

Risk of human papillomavirus infection and cervical intraepithelial lesions in Chinese renal transplant recipients

et al. 2022

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ObjectiveWhile human papillomavirus (HPV) infection in women is associated with cervical intraepithelial neoplasia and cervical cancer, HPV testing is not often performed in routine practice for renal transplantation patients. The genotype-specific prevalence of HPV and risk factors for HPV infection are still unclear.MethodsFrom 2010 to 2020, patients receiving renal transplantation surgery (referred to as RTRs), who had been screened for HPV infection one year after transplantation were enrolled. A comparison cohort of four age- and marital status-matched healthy individuals was selected for RTRs. The clinical characteristics and cervical screening results of RTRs were analyzed.ResultsOur study included 196 female renal transplant recipients (RTRs), none of whom had been vaccinated against HPV. Overall high-risk HPV (hrHPV) infection and abnormal cytology rates in the RTR group were 23.5% and 20.9%, respectively. The odds ratios of hrHPV infection and cervical intraepithelial neoplasia grade 2+ in RTRs vs. non-RTRs were 3.033 (95% CI, 2.013-4.568) and 3.628 (95% CI, 1.863-7.067), respectively. The prevalence of HPV16 in RTRs was much higher (30.4% vs. 8.3%, P=0.002). The multi-infection rate was much higher in HPV-infected RTRs (23.9% vs. 1.14%, P<0.001). The only risk factor for hrHPV infection was the duration of immunosuppression, which increased with time.ConclusionRTRs had significantly higher HPV infection rates and increased risks of HPV-related cervical premalignancies and cancers due to the immunosuppressed state. The duration of immunosuppression is a risk factor for transplant recipients. Female RTRs may benefit from more frequent cervical cancer screening after renal transplantation than healthy women. Prospective research on HPV infection dynamics in RTRs and optimal screening methods should be further explored in the future.

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“…The researchers also indicate that the administration of OC, regardless of the type, increases the likelihood of the persistence of HPV, which is the main etiologic agent of cervical lesions, invalidating the natural cleansing process (5) . A study carried out with women after transplants, who, therefore, were immunosuppressed, in a public hospital in the city of Niterói, in Rio de Janeiro, found the use of OC as the only risk factor, and that it increased that chance of STIs more than 7 times (19) .…”

Section: Discussionmentioning

confidence: 99%

“…The association of the habit of smoking with the presence of cervical changes not only increases the chances for the persistence of viral infections, such as the HPV, as it also determines the evolution of lesions and the progression towards cancer (21,22) . Studies have determined that the consumption of tobacco is a risk factor for alterations found in the pap smear test, even for passive smokers, with an increase of 1.7 times and 1.45 for the non-passive (19) . Another study found an increase of 43% in the risk of CINs (Cervical Intraepithelial Neoplasias) in the female population who both use OC and are smokers, in agreement with this study (23) .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated to cervical changes in units from the Single Health System

Treco

Vieira

Silva

et al. 2021

Rev. Gaúcha Enferm.

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Objective: To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. Method: This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. Results: The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. Conclusion: Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.

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Relationship between the risk factors for human papillomavirus infection and lower genital tract precursor lesion and cancer development in female transplant recipients

Cited by 4 publications

References 38 publications

Incidence of cervical intraepithelial lesions and human papilloma virus infection in female renal transplant recipients

Incidence of cervical intraepithelial lesions and human papilloma virus infection in female renal transplant recipients

Risk of human papillomavirus infection and cervical intraepithelial lesions in Chinese renal transplant recipients

Prevalence and factors associated to cervical changes in units from the Single Health System

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